. Several leading authorities, including the World Health Organization (WHO) and the U.S. Department of Health and Human Services (DHHS), have identified asthma as a priority disease area, and have called for action to reduce chronic disability and premature death due to asthma, to enhance HRQOL through education and improved asthma management techniques, and to improve asthma surveillance activities. In this Phase I project, we will develop and pilot test the Asthma Patient Telemonitoring System (APTS), {to our knowledge the first system that uses smartphone technology to routinely assess asthma control, rescue medication use, and symptoms; uses these data and NAEPP EPR3 guideline-driven interpretation criteria to identify patients at-risk for exacerbation; prompt real-time intervention via instant text messaging [short message service (SMS)]; and efficiently manages data for feedback reporting, data visualization, and electronic health record (EHR) integration. The APTS is a fully integrated data collection, analysis, reporting, and communication system designed to be utilized in the context of clinical care. It will be programmed for administration via RIM Blackberry and Google Android smartphones in Phase I and pilot tested for administrative feasibility. Feedback reports will be designed for patient self monitoring over time. Data and reports will be generated for clinicians to identify patients in need of treatment intervention and to monitor patient status over time.} Phase I Aims are to: (1) develop a prototype wireless mobile-ready phone application for asthma telemonitoring; (2) develop initial specifications for the delivery of real time patient-level data and patient, clinican, and aggregate feedback reports; (3) test the feasibility and acceptability of administering the prototype APTS in a clinical setting; and (4) disseminate project results through peer reviewed papers and conference presentations. The product of Phase I will be a prototype Asthma Patient Telemonitoring System (APTS) with preliminary evidence regarding feasibility, performance, and acceptability. In Phase II, we will build, test, and refine a fully functional mobile wireless APTS application, enabling real-time patient monitoring and patient and provider communication. The APTS will be programmed as a software contingent, cross-platform application for use on the RIM Blackberry, Google Android, Apple iPhone iOS, and Microsoft Windows Mobile. Our ultimate goals for this product are to reduce exacerbations and associated health care expenditures from asthma with a practical system that can be used effectively for daily monitoring and early clinical intervention. PUBLIC HEALTH RELEVANCE: The Asthma Patient Telemonitoring System (APTS) offers patients and clinicians a practical, user-friendly {remote monitoring system for the early identification of patients at-risk for exacerbation} that has the potential to improve patient-centered care and health outcomes, and ultimately decrease costs associated with asthma care management.